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(Renal Colic—Child; Renal Lithiasis—Child; Nephrolithiasis—Child; Renal Calculi—Child)
Kidney stones are crystallized material in the urine. These stones form in the kidneys or other parts of the urinary tract. Kidney stones may be made up of a variety of minerals in the blood. The most common are calcium, oxalate, or phosphate. Others stones may contain uric acid, struvite, and/or cystine.
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Some of the known causes of kidney stones in children include:
- Too much oxalate in the urine
- Too much calcium in the urine or blood
- Too much uric acid in the urine
- Tiny bacteria a stone can form around
- Inherited abnormality in the way the body handles cystine
- Foreign bodies in the urinary tract, such as stents or catheters
- Abnormal function of the urinary tract, such as neurogenic bladder
Factors that may increase your child’s chance of developing kidney stones include:
- Dehydration —not drinking enough fluids
- Eating foods high in salt
- Eating a ketogenic diet to help control epilepsy
- Mineral content of water your child drinks (hardness or softness of the water)
- Having family members who have had kidney stones or gout
- Having kidney stones in the past
- Being overweight
- Medical conditions, such as urinary tract infections or metabolic conditions
- Geographic location—residents of the Southeast United States have an increased risk
- Limited physical activity
- Foreign material in the urinary tract, such as a catheter
Occasionally, kidney stones do not cause symptoms, and they leave the body in the urine. Often a kidney stone can cause symptoms such as:
- Sudden, severe pain in the side of the body or mid- or lower back during movement
- Pain in the belly or groin area
- Nausea or vomiting
- Blood in the urine
- Burning pain when urinating
- Recurring urinary tract infections
You will be asked about your child’s symptoms and medical history. A physical exam will be done.
Images of the kidneys and urinary tract may be taken with:
Treatment depends on the size and location of the kidney stone. Treatment may include:
For small kidney stones, having your child drink plenty of water will help the body pass the stone in the urine. A special cup may be provided to catch the stone when it passes so that it can be analyzed. If your child is having a hard time keeping fluids down, hospitalization may be needed to receive fluids through an IV.
Your child may be advised to take:
- Over-the-counter pain relievers
- Prescription pain relievers
- Medication to dissolve or expel the kidney stone
Surgery may be needed if the stone is:
- Very large or growing larger
- Causing bleeding or damage to the kidney
- Causing infection
- Blocking the flow of urine
- Unable to pass on its own
Types of surgery include:
- Extracorporeal shock wave lithotripsy (ESWL)—uses shock waves to break up stones that are too large to pass
Ureteroscopy and stone basketing or laser lithotripsy—camera is used to locate the stone
- Stone basketing—A tiny basket is used to remove the stone.
- Laser lithotripsy—The stone is broken into smaller pieces with a laser if it is too large to remove.
- Percutaneous nephrolithotomy—uses a scope placed through a small tube in the back to remove a large stone (rare)
- Lithotomy—open surgery to remove a stone (rare)
Once a child has had one kidney stone, more stones are likely. To help reduce your child's chance of future stones:
- Have your child drink plenty of fluids, especially water. Avoid sodas.
- Make sure your child does not eat too much food that is high in salt, such as potato chips, french fries, or processed meats.
- A calcium-rich diet can help bind oxalate before it reaches the kidney. Encourage milk and yogurt.
- If your child is overweight, work with your child’s doctor to learn the safest way for your child to lose weight.
- Encourage water during sporting activities or other active playtimes.
National Institute of Diabetes and Digestive and Kidney Diseases
Urology Care Foundation
The Kidney Foundation of Canada
Borghi L, Meschi T, et al. Dietary therapy in idiopathic nephrolithiasis. Nutr Rev. 2006;64:301-312.
Kidney stones. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/k/kidney-stones. Updated March 2016. Accessed March 20, 2018.
Kidney stones. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/kidneystones.cfm. Updated January 25, 2016. Accessed March 20, 2018.
Nephrolithiasis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114904/Nephrolithiasis . Updated February 5, 2018. Accessed March 20, 2018.
6/23/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114904/Nephrolithiasis . Elderwy AA, Kurkar A, et al. Dissolution therapy versus shock wave lithotripsy for radiolucent renal stones in children: a prospective study. J Urol. 2014;191(5 Suppl):1491-1495.
- Reviewer: EBSCO Medical Review Board Kari Kassir, MD
- Review Date: 03/2018
- Update Date: 06/23/2014